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The Reproductive System > Lecture 11.1: Gynaecological Tumours > Flashcards

Lecture 11.1: Gynaecological Tumours Flashcards

1
Q

Where can Gynaecological Tumours occur?

A
  • Cervix
  • Endometrium
  • Myometrium
  • Ovary
  • Vulval tumours
  • Tumours of gestation
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2
Q

What age does Cervical Screening start?

A
  • 25
  • Every 3 years
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3
Q

When does Cervical Screening stop?

A
  • Every 3 years till 49 years
  • 5 yearly 50-64 years
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4
Q

What are they testing for in Cervical Screening?

A

HPV (16/18)

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5
Q

What is done if HPV positive/abnormal smear?

A
  • Abnormal/positive – referred for cytology +/-
  • Abnormal – colposcopy and cervix biopsy
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6
Q

Pleomorphism

A
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7
Q

Risk Factors for Cervical Carcinoma (6)

A
  • Sexual Intercourse
  • Multiple Partners
  • Immunosuppression
  • Cigarette Smoking
  • Early first pregnancy and increasing risk with each
    subsequent pregnancies
  • Familial tendency
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8
Q

How does cervical cancer present clinically? (5)

A
  • Early Stages are Asymptomatic
  • Abnormal Vaginal Bleeding
  • Post-Coital Bleeding
  • Blood Stained Discharge
  • Pain Radiating to Sacral Region
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9
Q

What are the 2 types of cervical malignancy?

A

1) Squamous cell carcinoma
2) Adenocarcinoma

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10
Q

Where can metastasis from cervical cancer via direct invasion happen? (4)

A

1) Around Cervix (Ureters)
2) Around Uterus
3) Rectum (causing fistulas)
4) Urinary Bladder (causing fistulas & ureteric
obstruction)

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11
Q

Cervical Carcinoma pattern of lymphatic spread (6)

A
  • Parametrial Nodes
  • Oburator Nodes
  • External Iliac Nodes
  • Common Iliac Nodes
  • Pre-Sacral Nodes
  • Par-Aortic Nodes
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12
Q

What are the 2 Types of Uterine Tumours? ()

A
  • Benign ‘fibroids’ (smooth muscle tumour of the
    myometrium)
  • Malignant adenocarcinoma of the endometrium
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13
Q

Risk Factors for Endometrial Adenocarcinoma (8)

A
  • Unopposed Oestrogen
  • Nulliparous
  • Early Menarche
  • Late Menopause
  • Iatrogenic
  • Obesity
  • Diabetes/Hypertension
  • HRT
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14
Q

What age is the peak incidence of Endometrial Adenocarcinoma?

A

55-65 years

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15
Q

Signs and Symptoms of Endometrial Adenocarcinoma (4)

A
  • Post Menopausal Bleeding
  • Difficult or Painful Urination
  • Pain During Intercourse
  • Pain and/or Mass in the Pelvic Area
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16
Q

What are the most common Myometrial Tumours? (3)

A
  • Smooth Muscle Leiomyoma(fibroids)
  • Benign Tumours
  • Single or Multiple
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17
Q

Malignant Mesenchymal Tumours (2)

A
  • Leiomyosarcoma (highly malignant, poor prognosis)
  • Endometrial stromal sarcomas
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18
Q

Ovarian Neoplasms

A
  • 80% benign
  • Mostly young women 20-45 years
  • Borderline tumours at slightly older age
  • Malignant tumours – older women 45-65 years
19
Q

Investigations for Ovarian Cancer (2)

A
  • CA125 Blood Test
  • Transvaginal Ultrasound
20
Q

Types of Epithelial Ovarian Tumours (5)

A
  • Serous
  • Mucinous
  • Endometrioid
  • Clear Cell
  • Brenner (transitional cell)
21
Q

What are Sex Cord Stromal Tumours?

A
  • These are neoplasms which frequently produce
    steroid hormones
  • May be benign or malignant
22
Q

Types of Sex Cord Stromal Tumours (3)

A
  • Granulosa Cell Tumour
  • Thecoma
  • Leydig Cell Tumour
23
Q

Embryonic Ovarian Germ Cell Neoplasms: What is an Immature Teratoma?

A

A type of malignant germ cell tumour that is often made up of several different types of tissue, such as hair, muscle, and bone

24
Q

Embryonic Ovarian Germ Cell Neoplasms: What is a Dysgerminoma?

A
  • A type of cancer that begins in germ cells in females
  • Malignant
  • Oocyte pure malignancy
  • Very radiosensitive, so good prognosis
25
Q

Embryonic Ovarian Germ Cell Neoplasms: What is a Monodermal Tumour?

A

Benign

26
Q

Extra-Embryonic Ovarian Germ Cell Neoplasms

A
  • All are Malignant
  • Yolk Sac Tumour
  • Choriocarcinoma
  • Endodermal Sinus Tumour
27
Q

What are Krukenberg Tumours?

A

It is a metastatic disease to the ovaries composed of mucin-rich signet-ring cells, comes from gastric cancer cells

28
Q

Extra-Mammary Paget’s Disease (EMPD)

A
  • It is a rare, slow-growing disease that is a pre-invasive
    form of skin cancer
  • Presents as pruritic red area on labia majora or
    around nipple
  • Mucin containing adenocarcinoma cells in the
    epidermis
29
Q

Gestational Trophoblastic Disease: Placental Tumours (3)

A
  • Hydatidiform Mole: Partial or Complete Mole
  • Invasive Mole
  • Choriocarcinoma
30
Q

What is a Hydatidiform Mole?

A
  • Is a rare mass or growth that forms inside the womb
    (uterus) at the beginning of a pregnancy
  • Grape like villi, holes
  • Monitored by HCG levels (serum and urine)
  • If level rises, patient will receive chemotherapy
  • Neoplastic potential of complete mole greater than
    partial mole
  • Followed up and patients advised not to get pregnant
31
Q

What is a Choriocarcinoma?

A
  • Rare malignant tumour associated with high mortality
  • Usually follows hydatidiform mole, can follow
    miscarriage or very rarely normal pregnancy
  • Malignant tumour of trophoblast: syncytio- and
    cytotrophoblast in layers
32
Q

What is CIN?

A

Cervical Intraepithelial Neoplasia
3 Degrees: I, II, III

33
Q

What part of the cervical epithelium more commonly becomes cancerous?

A

Ectocervical Epithelium

34
Q

What morphological change does HPV cause in the cervix?

A

Koilocytosis

35
Q

Normal vs Abnormal Ectocervical Epithelium

A
  • Large cells, small nucleus
  • Larger cells, darker stain, larger nucleus
36
Q

What does Carcinoma in situ mean?

A

Basement membrane is still intact, cancer has not invaded the basement membrane

37
Q

Why is it concerning if cervical cancer spreads to the ureters?

A
  • Causes compression/blockage of the ureters
  • This leads to back-flow of urine
  • This can cause kidney failure which can be fatal
38
Q

What is Gardasil?

A

HPV Vaccine

39
Q

Important Facts about Fibroids (5)

A
  • Oestrogen Dependent
  • Dysmenorrhea
  • Menorrhagia
  • Infertility
  • Issues during Pregnancy
40
Q

What substances do Germ Cell Tumours produce that can help us to monitor the disease? (2)

A
  • Beta-human chorionic gonadotrophin (B-HCG)
  • Alfa-feto-protein (AFP)
41
Q

What Types of Vulval Tumours are there? (4)

A
  • Squamous Carcinoma
  • Adenocarcinoma
  • Basal Cell Carcinoma
  • Malignant Melanoma
42
Q

Why does Obesity increase risk of breast and endometrial cancers?

A

Body fat has an enzyme called aromatase that converts testosterone into oestrogens, and oestrogen is linked to incidence of these cancers

43
Q

Why does Choriocarcinoma have a good prognosis (if caught on time) even though it has a high propensity for systemic metastasis to genital tract, lungs and brain?

A

Because the cancer cells are very rapidly dividing, it makes them incredibly susceptible to chemotherapy and radiotherapy

The Reproductive System (19 decks)

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